ENT - Ménière's Disease Flashcards
What is Ménière’s disease?
A long-term inner ear disorder causing recurrent attacks of vertigo, hearing loss, tinnitus, and fullness in the ear
What are the typical symptoms of Ménière’s disease?
- Hearing loss
- Vertigo
- Tinnitus
What is the pathophysiology of Ménière’s disease?
Excessive buildup of endolymph in the labyrinth of the inner ear, causing increased pressure known as endolymphatic hydrops
What is the typical age range of patients with Ménière’s disease?
40-50 years old
Unilateral episodes of
- Vertigo
- Hearing loss
- Tinnitus
How long do episodes of vertigo last in Ménière’s disease?
20 minutes to several hours
Can come in clusters over severeal weeks, followed by prolonged periods without vertigo
Vertigo not triggered by movement or posture
How does hearing loss present in Ménière’s disease?
Fluctuates initially, then gradually becomes more permanent
Sensorineural and generally unilateral, affecting low frequencies first
Hearing loss associated with vertigo attacks
How does tinnitus progress in Ménière’s disease?
Initially occurs with episodes of vertigo, then becomes more permanent and is usually unilateral
What other symptoms may be present in Ménière’s disease?
- Sensation of fullness in the ear
- Unexplained falls (‘drop attacks’)
- Imbalance persisting after vertigo resolves
- Spontaneous nystagmus - unidirectional
How is Ménière’s disease diagnosed?
Clinically, based on signs and symptoms, typically by ENT
Audiology assessment needed to evaluate hearing loss
What are the management strategies for Ménière’s disease?
- Managing symptoms during acute attacks
- Prophylactic medication to reduce frequency of attacks
What short-term options are available for managing symptoms during acute attacks?
- Prochlorperazine
- Antihistamines (e.g., cyclizine, cinnarizine, promethazine)
What is the prophylactic treatment for Ménière’s disease?
Betahistine
